International mortality from bullous diseases since 1950

National mortality figures hold information about our overall success in treating bullous disorders which cannot be found elsewhere. The official data, since 1950, for England and Wales, the Unites States, France, Japan, Scotland, Ireland and Denmark have been analysed after corrections for changes in the population structure and in the International Classification of Disease. A steep fall in deaths occurred in England and Wales between 1952 (121 deaths) and 1955 (55 deaths). The low rate persisted from 1955 to 1962 (40 deaths) when it fell to a steady even lower level lasting until the present. The United States figures showed a sharp drop in mortality starting about 2 years earlier (from 283 deaths in 1950 to 150 deaths in 1954), followed by a gradual fall to the present. Mortality in Scotland, Ireland and Denmark has followed the same general pattern but the figures from France, after a steady fall between 1951 (68 deaths) and 1965 (29 deaths), have risen again until 1971 (62 deaths). The number of deaths has not fallen in Japan but the data are difficult to interpret. The timing of the improvement in mortality in England and Wales, and in the United States, fits well with the introduction of systemic steroids into general use. A fall to about one-third of the presteroid level is in general agreement with the improvement recorded in smaller personal series from several centres.